| 摘要: |
| 【】 继发性甲状旁腺功能亢进(secondary hyperparathyroidism,SHPT)是慢性肾功能衰竭的常见并发症,而甲状旁腺切除术是治疗SHPT的重要手段之一。我国甲状旁腺切除术(PTx)使用率低,PTx手术适应症多采用国际指南推荐的标准,并被认为是高风险的外科治疗手段。文章主要对iPTH＞800pg/ml作为PTx适应症切点值和手术风险进行述评。在国内开展SHPT外科治疗的前瞻性随机对照研究,更低的iPTH切点值(<800pg/ml)作为PTx适应症和在CDK早期实施PTx而非ESRD,有可能给患者带来更好的获益和更低的手术风险,也更有助于制定适合我国SHPT患者的PTx适应症。组建MDT诊疗团队,有助于外科治疗SHPT的临床与研究工作的安全开展。 |
| 关键词: 慢性肾脏疾病 继发性甲状旁腺功能亢进 甲状旁腺切除术 述评 |
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| Comments on the Indication and risk of parathyroidectomy in Chronic Kidney Disease patients with secondary Hyperparathyroidism in China. |
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| Abstract: |
| 【】Secondary hyperparathyroidism (SHPT) is common complication in patient with chronic kidney disease(CKD), and parathyroidectomy (PTx) is one of the most important methods for the treatment of SHPT. The use of PTx wasSlow in China, and indications for PTx are referred to the international guidelines and is considered to be a high-risk surgical treatment. This article mainly reviewed iPTH > 800pg/ml as the cut-off value for indication and surgical risk of PTx. The therapeutic value of Whether lower iPTH cut-off value (<800pg/ml) for PTx and performed in the early stage of CKD instead of ESRD is applicable and bring better benefits for patients and lower surgical risks to be affirmed by prospective randomized controlled study in China. Only in this way can we develop surgical indications suitable for patients with SHPT in China. Constructing multidisciplinary team (MDT) Helps to improve the safety of clinical and research of surgical treatment for SHPT. |
| Key words: Chronic kidney disease Secondary hyperparathyroidism parathyroidectomy review |
